Stakeholders: We’re monitoring MedPAC

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Friday, December 1, 2017

WASHINGTON – The Medicare Payment and Advisory Committee offered a mixed bag of observations about the competitive bidding program at a recent meeting, but they likely won’t lead to any significant changes, say industry stakeholders.

MedPAC plans to recommend that CMS shift more products away from the “excessive” fee schedule to bid rates.

“There were different opinions among the various commissioners, with some saying it was great, but all they are doing is looking at the decrease in prices,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “No one was talking about access issues or anything like that.”

The committee plans to recommend CMS expand the bid program to include other product categories, including off-the-shelf orthotics and urological supplies, says Kim Brummett, vice president of payer relations for AAHomecare, which is developing a white paper on why urology and ostomy, in particular, are not good candidates for the program.

“When you competitively bid, you are bringing it down to the lowest common denominator and patients have such different needs,” she said.

AAHomecare will continue to monitor MedPAC, but Brummett says she doesn’t think there is immediate cause for concern. For one thing CMS doesn’t believe it has the authority to expand the bidding program without a statute. For another, stakeholders are slowly but surely getting the word out about issues with the program.

“I think there’s enough information going around CMS with the access to care study and some of the other stuff, that I can’t imagine CMS is actively entertaining adding more to it, at least not for 2019,” she said.

Of greater concern among MedPAC’s recommendations: requiring suppliers to be participating suppliers, thus limiting their ability to charge the beneficiary when billing unassigned. That would be a major problem in non-bid areas, says Bachenheimer.

“They are talking about protecting beneficiaries and limiting the amount you can charge them,” she said. “But, in the non-bid areas, that’s how a lot of people are surviving. It’s not financially feasible.”